Sahakian Barbara J, Bruhl Annette B, Cook Jennifer, Killikelly Clare, Savulich George, Piercy Thomas, Hafizi Sepehr, Perez Jesus, Fernandez-Egea Emilio, Suckling John, Jones Peter B
Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
Philos Trans R Soc Lond B Biol Sci. 2015 Sep 19;370(1677):20140214. doi: 10.1098/rstb.2014.0214.
In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.
神经精神疾病除了给个人带来痛苦和残疾外,对社会和政府而言成本也极高。这些疾病既常见又使人衰弱,会影响认知、功能和幸福感。认知增强药物,如胆碱酯酶抑制剂和哌甲酯,分别用于治疗阿尔茨海默病中的认知功能障碍和注意力缺陷多动障碍。其他认知增强手段包括特定的计算机化认知训练和设备。本文介绍了一种利用iPad上一款游戏的技术进步进行认知增强的新形式,该形式还能增强动机。原本作为治疗药物开发的哌甲酯和莫达非尼等认知增强药物,越来越多地被健康人使用。莫达非尼不仅影响“冷”认知,还能改善“热”认知,如情绪识别和与任务相关的动机。“聪明药”在生活方式中的使用引发了安全担忧以及伦理问题,包括强迫和社会不平等加剧等问题。作为一个社会,我们需要考虑哪种形式的认知增强(如药物、运动、终身学习)是可接受的,针对哪些群体(如军人、医生),在何种条件下(如战争、轮班工作),以及通过何种方式我们希望实现改善和繁荣。
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